What a D&C Is and When It’s Used
Dilation and curettage (D&C) is a short surgical procedure in which a clinician gently dilates the cervix and uses a small instrument called a curette to remove tissue from the inside of the uterus. It is commonly performed to investigate abnormal bleeding, confirm or remove molar pregnancy, manage miscarriage or incomplete abortion, and obtain endometrial tissue for biopsy. While sometimes used for early abortion, its most frequent uses in ongoing care are diagnostic and to address retained products of conception. The procedure may be done in a clinic, outpatient surgery center, or hospital, depending on patient needs, anesthesia choice, and local practice patterns.
How a D&C Is Performed: Steps and Anesthesia Options
Before the procedure, a clinician typically reviews medical history, performs a pregnancy test, and may obtain ultrasound imaging, blood tests, or infection screening. During the procedure, the patient lies on an exam table similar to a pelvic exam, and the clinician inserts a speculum to visualize the cervix. The cervix is gradually dilated with tapered rods, and a curette is introduced to remove uterine tissue. This tissue is sent to a pathology lab for evaluation. Patients may receive local anesthesia, sedation, or general anesthesia, depending on personal medical factors, anticipated complexity, and provider protocols. The procedure usually lasts less than 15 minutes, and most people are monitored briefly before discharge.
Typical Steps in a D&C
- Review of history, consent, and preparation.
- Pregnancy and infection screening as indicated.
- Cervical dilation using graduated rods.
- Gentle scraping or suction curettage to remove tissue.
- Collection of tissue for laboratory analysis and patient observation before discharge.
Recovery Timeline and What to Expect Afterward
Recovery from a D&C is usually brief, with many people resuming normal activities within a few days. Common experiences include mild cramping, light to moderate bleeding or spotting, and transient dizziness from anesthesia. Clinicians typically advise avoiding tampons, intercourse, and submersion in water for about two weeks to reduce infection risk. Follow-up appointments may be scheduled to review pathology results and ensure complete healing. Most people return to work or school the next day, depending on how they feel and the nature of their responsibilities.
Post-Procedure Checklist
- Arrange transportation if sedation or general anesthesia was used.
- Use pads instead of tampons for the first 1 to 2 weeks.
- Avoid heavy lifting and vigorous exercise for several days.
- Take prescribed pain medication or use over-the-counter options as directed.
- Attend follow-up visits and contact your clinician for heavy bleeding, fever, or severe pain.
Potential Risks, Complications, and Safety Considerations
D&C is generally safe when performed by trained clinicians, but like any procedure it carries risks. The most common complications are infection and uterine perforation, which are rare and often treatable. Other possibilities include retained tissue requiring a repeat procedure, injury to nearby structures, and reactions to anesthesia. For people with certain medical conditions, such as bleeding disorders or pelvic infections, additional precautions or alternative methods may be recommended. Discussing personal risk factors—such as medications, allergies, and prior surgeries—before the procedure supports safer planning and appropriate monitoring.
Diagnostic Uses and How Results Guide Care
When a D&C is performed for diagnostic purposes, the endometrial tissue is examined under a microscope to identify causes of abnormal bleeding, hormone imbalances, or precancerous changes. Findings can explain patterns such as heavy menstrual bleeding, postmenopausal bleeding, or irregular cycles. In some cases, a D&C helps detect endometrial hyperplasia or cancer at an early stage, enabling timely treatment. Results may also clarify whether additional imaging, laboratory tests, or further procedures are needed to create a safe, personalized plan.
Alternatives, Complementary Options, and Decision Factors
Depending on the clinical question, clinicians may consider alternatives such as outpatient hysteroscopy with directed biopsy, endometrial sampling in the office, or medical management before opting for surgery. Imaging with ultrasound or saline infusion sonography may provide useful information first. Factors that influence the choice include the need for tissue diagnosis, patient comfort, anesthesia risk, the likelihood of retained tissue, and local availability of options. Shared decision-making with a clinician ensures that chosen strategies align with patient goals, values, and overall health needs.